Individual provider Active NPI

Marco-Luis Moreno Miravite, DC

  • Chiropractor
  • Pasadena, CA
National Provider Identifier
1043023070
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC37173 Issued in CA
Practice address
131 N El Molino Ave Ste 180
Pasadena, CA 91101-5601
Phone
(626) 792-1221
NPI assigned
Jan 31, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC37173 CA Primary

Addresses

Primary practice location

131 N El Molino Ave Ste 180
Pasadena, CA 91101-5601

Mailing address

131 N El Molino Ave Ste 180
Pasadena, CA 91101-5601
Phone (626) 792-1221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250325002376 CA Practitioner - Chiropractic 9537682109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Smith Chiropractic Clinic IncGroup PAC ID 5294028999, 3 clinicians

Practice addresses (Care Compare)

131 N El Molino Ave
Suite 180
Pasadena, CA 91101-5601
Phone (626) 792-1221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC37173CAMDChiropractor
37173CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Smith Chiropractic Clinic, Inc. CurrentSince Mar 18, 2025 Accepting new patients
Smith Chiropractic Chiropractor PastSince Feb 2, 2025 Accepting new patients

Locations

131 N El Molino Ave
Ste 180
Pasadena, CA 91101
Phone (626) 792-1221

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1043023070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 N EL MOLINO AVE STE 180",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911015601",
            "telephone_number": "626-792-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 N EL MOLINO AVE STE 180",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911015601",
            "telephone_number": "626-792-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRAVITE",
        "first_name": "MARCO-LUIS",
        "middle_name": "MORENO",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC37173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.